Stoma Skin Soreness and Bag Hole Sizing Accuracy

Hi, 

My first post and glad to be speaking with people going through the same challenges that I am. I have an issue, which has been there for almost two years now. I have tried a few things which I will cover, but wanted to know if anyone else has gone through this and has a fix. 

On the very edge of my stomach skin and the stoma, I have a sore patch about an inch long and a few cm wide that comes and goes. I thought I had cracked it by using these new rings that have Manuka honey in them, as it seemed to resolve the issue and the soreness went away. 

It is back, and I am aware it's to do with how the bag fits snugly around the stoma but my weight has fluctuated so of course so will the stoma width. In short, I have tried: Manuka honey rings, various creams (but these aren't sticky enough so the ring lets waste in and makes it worse), Coloplast barrier spray and wipes (probably the best results so far) and a very strange red liquid provided by my stoma nurse which worked perfectly BUT again it makes the area not sticky so of course the rings come loose. 

Has anyone found a cream for sore patches that protects the wound/patch, allowing you to stick the rings and bag solidly around the stoma? I am working on getting two different sized bags to help with this issue. 

Finally, how did you all measure your bag hole successfully and accurately to ensure no skin is exposed? Did you use a partner or friend to help size it? I tried a mirror in a few ways, and I still don't think it's perfect. Again, any suggestions would be greatly appreciated. 

Apologies for the long email. 

Thanks,

Paul.

Hello Paul

Not long ago, a woman here, I cannot locate the post, measured the horizontal diameter of her stoma, then photographed the stoma. She then went to her computer and increased the image size gradually until the printed image on paper matched her horizontal measurement. Cut out the circle on the poster and transfer it onto the rear of your appliance. Retain the peel-off backing after you cut it for a perfect template. As for skin issues, I have not had many, but others will offer their solutions.

Good luck

A skin prep wipe or spray solved my skin problems.

Hi Paul, I have found that Stomahesive paste smeared on a sore spot and a ring on top of that works for me.

You should be referred to see a dermatologist if your stoma nurse can't sort your sore skin problem out. I would ask your nurse and GP about a referral.

I always wash my skin with Dermol 500 lotion as I have dry skin, and I use Sudocrem when I have sore skin. Rub a small amount in, wipe over with a tissue, and apply the bag.

A few pieces of paper are the easiest way to make a template as it is easier to cut when it's the right size. Then mark it on the backing plate you pull off the bag. You can use that in the future as your template. An even better way, as you're in the UK, is to see your stoma nurse. They can measure and make your template, then you know it's spot on. Always remember to measure your stoma once a month; they can change shape and size at any time, no matter how long you've had one.

I always used Domeboro soaks to heal it as it won't interfere with sticking the pouch. It's packets of powder that you mix with warm water. I used a paper towel and soaked the paper towel and wrapped it around my stoma after removing my pouch and let it sit there for a good while. There will be more liquid in the bowl so you can get a fresh paper towel and wet and change out. After, I clean the area as usual and apply my pouch. You can do this once a day until it heals. Make sure to use paper towels to rinse the area with water after. My stoma nurse turned me onto this years ago and it works like a charm. When you have sores like that, you may want to change more often until it gets healed up.

Be careful when you take the bag off. If you're just pulling it off, it will rip your skin. Use an adhesive remover wipe or spray for ostomy. You may just be ripping your skin there because, for some reason, my bag is the hardest to remove at the bottom and I've ripped my skin there before pulling it off.

As far as measuring, yes, it's a struggle and especially with weight loss or gain. I get mine precut now because when I cut them myself, they used to rub on the stoma and bleed. They sell an instrument online that cuts them like the manufacturer and perfect. As far as sizing, it's tricky and I always get a stoma nurse involved, but you can do it yourself with the guides that the pouch manufacturer gives out. You don't want to cut too small or too large; that can cause leaks. I don't keep mine totally snug around the stoma but snug enough, and I use an Adapt Cera ring and a Convatec Active Life convex pouch. Sticks like a charm. I don't use a skin barrier because I learned it can build up and is hard to remove, and if you don't get the build-up off, it interferes with the sticking of the pouch, but it's good when needed. I'm keeping things simple these days. Sometimes less is more.

The Domeboro says rash relief, but it also has helped me with sores as it has an astringent in it. You can use it for ostomy rashes as well.

Are you getting too snug of a fit? Also, consider that you may be allergic.

Hi Paul,

This post makes sense after I read your other post about the CliniMed Ultraframes. Redness in only one area tends to rule out an allergic reaction, as it would be more widespread. What I'd guess you're seeing is wetness under your barrier in the area that's red. You mentioned in your other post that you have a lot of gas during the night and the CliniMed Ultraframes were stopping your leaks. But they're just stopping your leak from escaping out the side of the barrier, not around your stoma. The Ultraframes are just trapping the leak, not stopping it. I'd bet when you have a lot of gas in your bag your barrier ring is losing contact in the area of your skin that's sometimes red. Wetness will cause your skin to get irritated, so it will come and go as you describe. I don't have the gas problem you do, but my stoma "sweats" a lot, and that moisture can make its way under my barrier ring, which makes my skin red in that area. The gas you have is probably blowing that seal between your stoma and the ring, allowing moisture to get under the ring where your skin is red. When you remove your barrier to replace it, mark it at the top with a Sharpie or Magic Marker. Then when you remove it, flip it over to see what's on the barrier in the area where your skin is red. If it's wet... you found the culprit.

I use Domeboro as Hi explained above, followed by a 50/50 vinegar/water soak, both for 10 minutes each, and my skin looks brand new. Just make sure your skin is completely dry before putting on your new ring and barrier. I'd say skip the vinegar at first and just use the Domeboro... or any generic astringent solution. The generics are MUCH cheaper than the Domeboro and are the same product. And if your redness turns out to be something else... inspecting your barrier closely when you remove it will tell you what's up. Let us know.

As for making a template, I just used to use the clear plastic you remove from a barrier and cut a hole a little bigger than your stoma, so it goes over your stoma and doesn't touch on any sides. Then take regular masking tape and lay the tape around your stoma in radial pieces like the aperture of a camera lens (see pic below). The more pieces of tape you use, the closer you'll get to your true stoma shape. When you have it all laid up, just remove it and transfer the hole dimensions to another piece of plastic, then keep that as your template. Should only take a minute or so.

;O)

I really like that method with tape for getting a true fit! Genius idea!

Hi PaulG666

Over the years, for sore areas by my stoma, I've used a layering of Stomahesive powder and Skin Tac… apply a light dusting of powder, fan off the excess, then dab it with Skin Tac, then put on your appliance as usual. Once the area is healed, a good idea that I finally tried are those Brava rings… they were a game changer for me… they keep the skin around the stoma perfectly sore-free.

Love this idea!